CPAP Set-Up

NIPPV 3 machines are used throughout the trust to deliver NIV and CPAP – and should be commenced in ED if transfer to ward/ICU is adding significant delay

  • NIV/CPAP  is an Aerosol Generating Proceedure (AGP)
    • Staff must wear full APG PPE
    • In Side room with a door
    • Door Marked with APG sign – HERE
  • CPAP/EPAP levels of 8-15cmH2O

This video demonstrates how to set up CPAP on the NIPPV 3

 

  • BTS has released the guidanceHERE 
    • Masks
      • Well-fitting oronasal facemasks, masks over the total face, or helmets should produce least droplet dissemination.
      • Vented masks could worsen contamination of the environment
      • Any patient on acute NIV should be managed with a non-vented mask and an exhalation port in the circuit.
      • Ensure that the ventilator mode employed supports the use of non-vented masks and exhalation ports.
      • Sequence of actions: Mask ON THEN turn CPAP ON; Turn CPAP OFF THEN  mask OFF
    • Filters
      • A viral/bacterial filter should be placed in the circuit between the mask and the exhalation port (Figure below).
      • This viral/bacterial filter can replace any filter at the machine end of the circuit.
      • Viral/bacterial filters should ideally be changed every 24 hours or sooner. (There is a risk that they will become wet due to exhaled gas and that this may increase resistance to flow.)
      • An external humidifier must not be used.
      • Blocked filters can be mistaken for clinical deterioration; this issue is remedied by changing filters.
    • Oxygen – entrained at patients end (on mask)

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